Original articleExperimental endoscopyEndoscopic full-thickness resection and defect closure in the colon
Section snippets
Animals and preoperative preparation
The study was conducted at the animal facility in Beichlingen, Thüringen, Germany, after approval of the Animal Care and Use Committee. Fourteen female domestic pigs with a mean weight of 28.1 kg (range 20-36 kg, SD 5.0) were used. The animals were fasted from solid food for 48 hours before surgery, but were allowed full access to water and milk. Preanesthesia sedation consisted of ketamine 2 mg/kg and xylazine 2 mg/kg. General anesthesia was achieved using isoflurane, nitrous oxide (N2O), and O
Results for eFTR with secondary OTSC closure
Twenty eFTRs were performed in 10 animals without prior placement of an endoloop. Outcomes are provided in Table 1.
The eFTRs produced complete colonic wall defects in all cases. Adequate closure of eFTR defects (size 2.4-5.5 cm) was successful in 9 out of 20 cases (45%). Defects ranging from 2.4 to 2.7 cm were successfully repaired in 5 out of 6 cases (83%), and the largest resections that left defects ranging from 2.9 to 5.5 cm were adequately closed in 4 out of 14 cases (29%). In 5 cases
Discussion
This pilot study demonstrates several strengths and weaknesses of eFTR in combination with OTSC closure. The grasp-and-snare technique is very straightforward and resulted in specimens up to 5.5 cm in size. These results are in accordance with an earlier report using a similar technique for gastric eFTR.22 The tissue anchor can be easily deployed in the middle of any targeted resection area and allows for reliable tissue anchoring, pseudopolyp creation, and full-thickness resection.
The most
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. (Research support for this study was provided by Ovesco Endoscopy and Olympus Germany.)
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